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California fires leave 31 dead, a vast landscape charred, and a sky full of soot.
The reach of the blazes is spreading dramatically further by the day, as thick plumes of smoke blow through population centers across the Bay Area.
SONOMA, Calif. — Some of the worst wildfires ever to tear through California have killed 31 people and torched a vast area of the state’s north this week, but the reach of the blazes is spreading dramatically further by the day, as thick plumes of smoke blow through population centers across the Bay Area.
Everything now smells burnt. Hills and buildings are covered in a haze. Residents nowhere near the front lines of the fires now venture out wearing air masks. On a hillside above the Russian River, a broad and menacing band of fire is turning a blue sky into a gray miasma of soot.
Air-quality, based on levels of tiny particles that can flow deep into the lungs, is rated “unhealthy” across much of Northern California, and smoke has traveled as far as Fresno, more than 200 miles to the south. The effects are many: schoolchildren are being kept inside during recess, the Oakland Raiders canceled their outdoor practice on Thursday to prevent players from breathing in the bad air, and doctors are reporting an increase in visits and calls from people with lung and heart trouble.
It is the 31 deaths, however, a toll that surpasses the official number of people killed by the single deadliest wildfire in state history, that has horrified Californians. The Griffith Park fire of 1933, in Los Angeles, killed 29 people despite burning a mere 47 acres, according to officials.
Late Thursday, the authorities said they had identified 10 of 17 people who were killed in Sonoma County. Most were in their 70s and 80s, and most were found in houses. One was found next to a vehicle.
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“We have found bodies that were nothing more than ash and bones,” said Robert Giordano, the Sonoma County sheriff. In some cases, he said, the only way to identify the victims was by the serial numbers stamped on artificial joints and other medical devices that were in their bodies.
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William Roman, 13, wore a face mask as he watered plants in Santa Rosa. Credit Jim Wilson/The New York Times
Because the fires have sent so many residents scrambling for safety, separating them from relatives, the authorities have received reports of 900 missing people and have deployed 30 detectives to track them down. Officials said they had confirmed the locations and safety of 437 people and were still looking for the other 463.
If they cannot find them by phone or online, they send search and rescue teams with cadaver dogs to the homes — if the homes are accessible, which in many cases, they still are not.
“It’s going to be a slow process,” Sheriff Giordano said.
Statewide, there were 21 major fires still burning on Thursday, which had consumed more than 191,000 acres since the outbreak began on Sunday night, said Ken Pimlott, the chief of Cal Fire, the state firefighting agency. The number of separate fires rises and falls often, as new blazes flare up and old ones merge, but the size of the devastated area has grown steadily.
Underscoring the vast scale of the crisis, a line of fire that appeared to span at least two miles descended into Alexander Valley, a wine grape growing region in Geyserville along the Russian River. Thick white columns of smoke poured from the forested hillside above the vineyards as the fire crept down into the valley.
Health officials were particularly focused on young children, who are at a higher risk than adults from dirty air. They breathe faster and take in more air than adults because they run around more. They also have smaller airways, so irritation in those narrower pipes is more prone to cause breathing trouble.
“People with pre-existing heart and lung disease, the elderly and young children should stay in the house with the windows closed,” said Dr. John Balmes, an expert on the respiratory effects of air pollutants at the University of California, in both Berkeley and San Francisco.
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Firefighters in Sonoma looked at a wall of smoke rising from the Norrbom Fire burning across the valley. Credit Jim Wilson/The New York Times
Certain masks can filter out fine particles, but surgical masks are useless, and so are the ones used to protect against big particles. The masks that work are a type called N95, available in many hardware stores.
Nancy Barkley, 40, a nurse from Indiana who is on a 13-week assignment unrelated to the fire emergency, drove dozens of miles from Santa Rosa to find face masks.
“I kept on driving because they were out everywhere,” she said, pulling down her surgical mask to talk.
Northern California is accustomed to wildfires and occasional wafts of smoke that drift with the winds. But nothing like this.
“I’ve lived here 50 years — I’ve never seen it this bad,” said Paul Ackerley, a 90-year-old World War II veteran.
Mr. Ackerley was walking through his neighborhood Wednesday when a woman stopped her car and offered him a mask.
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Smoke hung in the air in Sonoma’s town square on Thursday. Credit Jim Wilson/The New York Times
People closest to the fires have the greatest risk of health problems. There, heavy smoke can include toxic substances emitted when man-made materials burn. Plastics can release hydrochloric acid and cyanide.
“Smoke inhalation can kill you,” Dr. Balmes said. “There’s no doubt about that, but it’s all dose-related. If you breathe in a lot of smoke from any fire, especially a fire in a building with man-made materials that can emit these toxins, you basically have chemical burns of the airway.
“Just like your skin can slough off when it’s burned, the airway lining can slough off. It can be life-threatening. People have to be intubated and put on a ventilator,” he said.
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Hospitals near the worst fires are struggling as they continue to take in patients.
At Santa Rosa Memorial, the city’s largest hospital, technicians installed a large air filtration system to clear smoky air from the hospital lobby. The hospital has handled 130 fire-related cases since Sunday night, when the fires began. Bus drivers in the city have been issued face masks.
“We’ve seen patients who have chronic lung disease, like emphysema, generally older patients, which is really exacerbated by the smoke,” said Dr. Chad Krilich, chief medical officer for St. Joseph Health, which includes Santa Rosa Memorial, another hospital and other facilities in Sonoma County.
“For some of them, it’s really life-threatening,” he said, adding that patients even without asthma or other lung problems are coming in with breathing trouble. Most are being treated in the emergency rooms, which would normally see 105 to 135 patients a day, but are now seeing 150 to 180 a day.
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Capt. John Clays lit a backfire on Wednesday in Sonoma County. Credit Jim Wilson/The New York Times
Their inpatient count rose at first, but they have been transferring patients elsewhere, “because we are at risk of evacuation, too,” Dr. Krilich said, adding, “We know at least 108 of our employees are homeless, and 46 others have had to evacuate.”
Steve Huddleston, vice president for public affairs of NorthBay Healthcare, said the network has two small hospitals and three outpatient clinics in Solano County, east of the fires. One of its outpatient clinics is less than a mile from the fire line, but still operating.
In the emergency rooms and the clinics, he said, “we’re seeing 100 patients a day with respiratory distress and asthmatic attacks from the smoke.”
Many have chronic lung disease or asthma, but not all.
“All of our beds are full, and they have been for two days,” Mr. Huddleston said.
He added: “We’re on the edge of feeling overwhelmed. The staffing is becoming challenging. We’ve had half a dozen of our physicians or staff members lose their homes in the fires. We have staff members who live in the evacuation zones, and they’re trying to get their belongings and their loved ones out of there.”
In areas directly affected by the fires, many schools have canceled classes for the week, leaving parents scrambling.
On Thursday, William Roman, 13, a middle-school student, was helping his grandfather in a landscaping job at a strip mall in Santa Rosa, watering plants — with a face mask on.
“If we’re going to play outside we need to wear a face mask — that’s what my mother says,” William said.
Depending on the winds, the smoke can range from heavy to none. In parts of Santa Rosa on Thursday, there was something resembling a blue sky. Yet even when the smoke was not visible, the outdoors smelled like a fireplace.
Thomas Fuller reported from Sonoma, Calif., and Denise Grady and Richard Pérez-Peña from New York. Matt Stevens contributed reporting from New York.
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Hurricane damage in Puerto Rico leads to fears of drug shortages nationwide.
Two weeks after Hurricane Maria hit Puerto Rico, manufacturers are rushing to get their plants on the island back on line to avoid production problems.
Hurricane Damage in Puerto Rico Leads to Fears of Drug Shortages Nationwide
By KATIE THOMAS and SHEILA KAPLANOCT. 4, 2017
A factory owned by the pharmaceutical company Mylan, which makes the childhood leukemia drug methotrexate, in Caguas, P.R., is one of 80 drug manufacturing plants struggling to stave off shortages of critical medicines in the aftermath of Hurricane Maria. Credit Erika P. Rodriguez for The New York Times
Federal officials and major drugmakers are scrambling to prevent national shortages of critical drugs for treating cancer, diabetes and heart disease, as well as medical devices and supplies, that are manufactured at 80 plants in hurricane-ravaged Puerto Rico.
Pharmaceuticals and medical devices are the island’s leading exports, and Puerto Rico has become one of the world’s biggest centers for pharmaceutical manufacturing. Its factories make 13 of the world’s top-selling brand-name drugs, from Humira, the rheumatoid arthritis treatment, to Xarelto, a blood thinner used to prevent stroke, according to a report released last year.
With business of nearly $15 billion a year at stake in Puerto Rico, drug companies and device makers are confronting a range of obstacles on the island: locating enough diesel fuel for generators to run their factories; helping their employees get to work from areas where roads are damaged and blocked, electricity is down and phones don’t work. Companies have taken out radio ads pleading with workers to check in. The pharmaceutical and device industries contribute to the employment of nearly 100,000 people on the island, according to trade groups.
“Some of these products are critical to Americans,” Scott Gottlieb, the commissioner of the Food and Drug Administration, told a congressional panel this week. “A loss of access could have significant public health consequences.”
Dr. Gottlieb, who visited F.D.A. staff in Puerto Rico last week, told the House Energy and Commerce Committee’s subcommittee on Health: “We have a list of about 40 drugs that we’re very concerned about. It reflects maybe about 10 firms.”
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Thirteen of the drugs, Dr. Gottlieb said, are “sole-source,” meaning the product is made only by one company. Those include H.I.V. medications, injectable drugs and sophisticated medical devices, although he did not name the products. The biggest problem, he said, was not damage to the factories, but the instability of the electric supply. Manufacturers are worried that a long-term lack of connection to a major power grid could jeopardize their products, and are also wary of relying on the more limited electrical grids that the territory is likely to activate as a first step to restoring power.
One of the drugs F.D.A. officials said they were concerned about was methotrexate, which treats childhood leukemia and other diseases. It has been scarce, off and on, for several years. Mylan makes the product in Puerto Rico, and all five manufacturers of the injectable form of the drug have reported shortages of the product, according to a list maintained by the American Society of Health-System Pharmacists.
In a statement, Mylan did not address the methotrexate shortage but said it was “working closely with F.D.A. to help address drug shortage concerns.” Its plant has sources of water, electricity and communication, and the company said it is “working on ways to make them sustainable for manufacturing purposes.” Like other companies, it said it was focusing on helping employees and other residents of the island with basic needs, including chartering a cargo plane carrying essential goods to deliver to them.
Several pharmaceutical and medical device companies said that their factories were coming back on line with the assistance of generators and that they did not anticipate supply shortfalls. But others said the situation was precarious. Drug companies depend on consistent refrigeration to avoid shortages. And device makers are wondering when the power grid would be back up, which some officials have predicted could take months.
“Everybody is struggling to get diesel fuel — that’s just widespread,” said Antonio Medina, an independent consultant who until last year was executive director of the Puerto Rico Industrial Development Company, a government-run group that promotes manufacturing.
Wilberto Maldonado, a pharmaceutical consultant in Puerto Rico, said drug and device makers were navigating a logistical “nightmare,” especially when trying to get access to fuel for their generators.
With phone lines down, “many employers have people still unaccounted for,” Mr. Maldonado said in a message through LinkedIn. “This may not improve, as telecom service providers are also depending on backup generators.”
Industry officials have sought to strike a delicate balance in making their case for help without appearing to divert precious resources from hospital and other emergency services. Returning the drug and device industry to its feet, however, is crucial for ensuring the island’s economic recovery as well as safeguarding the supply of medicines and devices to the rest of the United States.
If the manufacturing plants are slow to fully recover, some companies could shift their production elsewhere, said Deepak Lamba-Nieves, research director at the Center for a New Economy, a nonpartisan economic think tank in Puerto Rico. “That may have medium and long-term consequences for an island that is going to be hugely and severely impacted by this hurricane for many years to come,” he said.
Lobbyists and executives from health care companies met Tuesday with the Department of Health and Human Services and the Federal Emergency Management Agency to make their pitch for assistance.
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Fallen wires hung just outside the Mylan facility on Wednesday. Challenges to getting the drug manufacturers up and running again include locating diesel fuel to power their generators and helping their employees get to work in areas where roads are blocked, electricity is down and phones don’t work. Credit Erika P. Rodriguez for The New York Times
AdvaMed, the trade group for the device makers, said its requests included priority access as the electricity grid is restored.
“Even if companies are fine now with diesel fuel, we want to make sure we’re in the queue in terms of priority,” said Greg Crist, a spokesman for AdvaMed. “Because if there is an electricity shortage well into November, for example, how can we as an industry make sure we are in line for those priorities, once you’ve taken care of hospitals and essential needs?”
While AdvaMed has outlined its members’ challenges, its pharmaceutical counterpart — the Pharmaceutical Research and Manufacturers of America — provided fewer specifics and referred questions to Healthcare Ready, an industry group that is coordinating the recovery operations in Puerto Rico.
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Several drug companies said that while their plants lost power and were forced to shut down, they were not anticipating a disruption in supply. “We have a strong local team working through incredible logistical challenges, and we’re seeing progress each day,” said Ernie Knewitz, a spokesman for Johnson & Johnson. Tylenol and Prezista, an H.I.V. drug, are among the products that the company manufactures in Puerto Rico. “We are also closely monitoring our product inventory levels and will work to ensure all critical needs are met.”
The industry’s rosy outlook, presumably offered in part to assure nervous shareholders, contrasted with the concern expressed by Dr. Gottlieb.
“We know that the grid is going to be unstable for a long period of time,” Dr. Gottlieb said. “The generators were never meant to operate for months and months on end.”
Erin Fox, a drug shortage expert at the University of Utah, said she and other hospital pharmacists were monitoring the situation, and were worried that the storm’s impact could exacerbate the United States’ already dire drug-shortage problem.
Ms. Fox said companies typically do not disclose where they manufacture their drugs because it is considered a trade secret. Several companies declined to list which products they made in Puerto Rico.
“Because we have no transparency around that,” she said, “it’s actually hard to know the true impact of this.”
Baxter, a medical-supply company, has said that it is limiting shipments of products made in Puerto Rico to conserve its supply, including small bags of dextrose and saline, which are used by hospitals to prepare medication. Hospitals will be limited to their typical monthly shipment to prevent some institutions from stockpiling the products.
Ms. Fox said hospitals rely on these small bags of saline solution to mix medicines for patients, and “an allocation doesn’t guarantee that you will get some.”
A few years ago, Baxter was at the center of a shortage of large saline bags that led to state and federal investigations into its business practices.
Baxter said that its three manufacturing sites in Puerto Rico sustained “some damage,” and that “limited production activities” had resumed at all of its plants.
Puerto Rico has been a hub of drug manufacturing for decades — companies were lured to the island because of tax breaks and its access to the United States market, along with skilled employees who worked for lower wages. About a decade ago, expiring tax incentives led to a wave of factory closings, stoking fears that the industry was in jeopardy.
Today, the drug and device industries remain a mainstay of the Puerto Rican economy. Pharmaceutical and medical manufacturing accounted for nearly three-quarters of Puerto Rico’s exports in 2016, of $14.5 billion, according to the federal Bureau of Labor Statistics.
“These are some of the best jobs,” Mr. Medina said.
Dr. Gottlieb hopes the companies stay there.
“A highly skilled, highly dedicated and highly productive Puerto Rican work force enables the success of the industry,” Dr. Gottlieb said. “If they decide to relocate after this disaster, it would jeopardize the island’s economic future.”
A version of this article appears in print on October 5, 2017, on Page A1 of the New York edition with the headline: Drug Shortages Are New Concern In Wake of Storm. Order Reprints| Today's Paper|Subscribe
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RECENT COMMENTS
Steve 4 hours ago
Its plant (Mylan) has sources of water, electricity and communication, and the company said it is “working on ways to make them sustainable...
Kittredge White 4 hours ago
How generous, how sweet! It's really funny how no one gave a hoot about PR until corporate bottom lines were at risk...
Mountain Dragonfly 4 hours ago
Great time to put some money into getting these operations back up and running. Would be a political win as it would provide JOBS!!!! and...
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Puerto Rico’s slow-motion medical disaster.
Hurricane Maria left a ruined island and 16 Puerto Rico residents dead. But public health experts worry that figure could climb higher in the coming weeks, as many on the island fail to get medicines or treatment they need for chronic diseases.
Hurricane Maria left a ruined island and 16 Puerto Rico residents dead. But public health experts worry that figure could climb higher in the coming weeks, as many on the island fail to get medicines or treatment they need for chronic diseases. Roads are blocked, supplies are stuck at the ports, and only 11 of Puerto Rico’s 69 hospitals are open. Doctors at one children’s hospital were forced to discharge 40 patients this week when their generator ran out of diesel fuel.
But the immediate need for treatment is only the beginning of the island's public health challenges. With the island’s entire power grid knocked out, Puerto Rico’s massive pharmaceutical manufacturing industry—which provides 30 percent of the island’s gross domestic product and 90,000 jobs—has been shut down. FDA administrator Scott Gottlieb announced this week that his agency is trying to shift production to the mainland US to prevent shortages of cancer drugs, immunosuppressants for transplant patients, and medical devices for diabetes patients. Bringing Puerto Rico back online will make a big difference for people living both on—and off—the island.
In the short term, energy is essential to keeping patients alive. Medicines like insulin to treat diabetes or tetanus vaccines need to be kept cool. That means either in a refrigerator at 45 degrees Fahrenheit (for seasonal flu or tetanus vaccines) or at room temperature, which is about 72 degrees (for insulin). But without air conditioning, Puerto Rico’s tropical climate is hitting the upper 80s this week. “Refrigeration and cold storage are really big issues, and will be for the forseeable future,” says one former federal emergency response official who asked not to be identified.
The patients most affected by the failing cold chain will be those with chronic conditions. One-fifth of Puerto Rico's population has some kind of disability, including half of those above age 65. Its 3.5 million residents have the highest prevalence of diabetes in the United States—nearly 13 percent compared to 8.7 percent on the US mainland. That helps make Puerto Rico the most vulnerable US territory to a natural disaster like Hurricane Maria, according to a recent study by the Association of State and Territorial Health Officers .
Federal health officials say they are already seeing patients come into emergency clinics with chronic disease related problems. “People with the most dire need are dialysis patients,” says Lt. Cmdr. Garrett Martin-Yeboah of the US Public Health Service and the national clinical pharmacist to the Department of Health and Human Service’s assistant secretary for emergency preparedness and response. “They are on a good number of prescription medications. Because of the volume of medications and tenuousness of their condition, those are some of the patients we are concerned about.”
The immediate refrigeration problem is solvable. Martin-Yeboah said a squad of federal emergency care doctors who were stationed on the island before Maria struck brought battery-powered mini-fridges that can run four days without power. They also brought their own diesel generators—though a week after the storm left, there is still not enough fuel to run them. “There are some challenges in Puerto Rico with fuel and things like that,” says Martin-Yeboah, who coordinates medicines and supplies for HHS doctors. “We’ve had to go to the airport to retrieve medical supplies,” she says. “Our suppliers can get them to Puerto Rico, but can’t get it to the site.”
The Navy hospital ship Comfort, which was finally dispatched this week, may also help in the short-term, especially for trauma patients. The converted supertanker will bring 1,000 beds, 12 operating rooms, a CAT-scan, and radiology capabilities to Puerto Rico. Meanwhie, emergency responders are using ham radios to reach some communities and even considering air-dropping medicines into villages, according to Nicolette Louissaint, executive director of Healthcare Ready, a group that coordinates post-disaster medical supply chain between public agencies and private suppliers such as pharmacies and drug manufacturers.
“The most important part is how we support the patients,” Louissant says. “These disaster responses are massive logistical operations. We have to do unusual things. Folks are looking at how you can get up to the mountains, and what solutions to move medicines to people but also people to medicines.”
Louissant noted that less than 10 percent of the island’s pharmacies were open as of Wednesday. Overall, there is no panic over medicines, according to health officials working in Puerto Rico. But they are prepared for the situation to worsen if conditions don’t improve quickly. Chronic diseases like cardiovascular disease and diabetes are often not counted in the final toll of natural disasters like Hurricane Maria. “These people end up dying from things that are preventable under ordinary circumstances,” said the former federal emergency official. “That’s what is going to start happening.”
But long-term, the effects of Puerto Rico's collapse may ripple far beyond the island. Twelve of the top 20 global pharmaceutical and biotechnology companies have manufacturing facilities on the island, according to the Puerto Rico Industrial Development Company. As a result, Puerto Rico manufactures seven of the top 10 drugs sold globally including AstraZeneca's cholesterol treatment Crestor, Abbvie arthritis drug Humira, and Johnson & Johnson-owned HIV drug Prezista, USA Today reported. Those three companies have said supplies of their drugs are in good shape and drugmakers are working to get production up and running. Still, Puerto Rico officials say it may be months before the island's power grid is fixed.
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Puerto Ricans still waiting for aid a week after Maria's devastation.
A week after Hurricane Maria ravaged Puerto Rico, millions of the U.S. commonwealth's residents are struggling to survive without basic necessities.
(CNN)A week after Hurricane Maria ravaged Puerto Rico, millions of the US commonwealth's residents are struggling to survive without basic necessities.
In the town of Utuado, Lydia Rivera has started to ration crackers and drink rain water to keep her two grandchildren alive.
"No water, no food," Rivera told CNN. "It's nobody's fault. It's the weather. You have to go on."
The storm hit the US territory last week, killing at least 16 people and knocking down power, communication and water grids across the island. But the recovery efforts there have been markedly different from those in Texas and Florida after recent hurricanes.
Lydia Rivera is rationing crackers to keep feeding her grandchildren.
In coastal communities, homes were damaged by the sea surge and hundreds of palm trees were stripped of fronds. In mountain towns, families had to be evacuated because homes were threatened by mudslides.
On the beach, Maria brought waves.
In the mountains, Maria brought mud.#PuertoRicoNeedsHelpNow pic.twitter.com/Ifn44oujz1
— Bill Weir (@BillWeirCNN) September 26, 2017
Lives are at stake
With nearly all 1.6 million electricity customers in Puerto Rico without power, the lack of fuel is a key problem across the island.
People are relying on generators to keep appliances such as air conditioners, medical devices and refrigerators running.
Many hospitals are struggling to treat patients and scores of people are lining up with gas cans for hours.
Twelve children hospitalized at the San Jorge Children's Hospital in San Juan depend on ventilators to survive, but the hospital has only a limited amount of fuel for generators, said Domingo Cruz Vivaldi, the hospital's executive director.
The hospital is the largest private children's medical center in the Caribbean. When the hospital ran out of diesel Monday, the ventilators had to run on batteries for hours until another hospital offered them fuel.
"We were very thankful for that. We were very lucky," he said.
The hospital is working to secure more gas, Cruz Vivaldi said, because that diesel will only last for about two days.
At another hospital in San Juan, two people died in an intensive care unit after it ran out of diesel, officials said.
'People are starting to get desperate'
Before sunrise every day, dozens of people hauling multiple red plastic gas cans begin lining up at gas stations. They need fuel to start up their cars in case of an emergency or to keep generators running at home.
Some wait for up to six hours armed with lawn chairs and umbrellas.
"If the gasoline arrives it will fix our problems. Because people are starting to get desperate," said Utuado's Mayor Ernesto Irizarry.
At least 60 people have been arrested for violating the overnight curfew ordered by Gov. Ricardo Rosello to keep the island safe.
Thirty-six people have also been arrested for looting and theft in Humacao, Caguas, San Juan and Bayamon, Puerto Rico Police Superintendent Michelle Hernandez told CNN.
People waiting line to buy gas in Rio Hondo, Bayamon, Puerto Rico.
Federal relief efforts
With supplies running out, many of the island's residents are collecting water from mountain streams.
Harry Torres said the water is all they have for cleaning and drinking until help comes. They've heard on the radio that FEMA trucks loaded with supplies have arrived on the island.
"We haven't seen any," Torres told CNN.
Puerto Rico and the US Virgin Islands have seen fewer personnel since Hurricane Maria hit than Texas and Florida during the recent hurricanes.
In a tweet on Monday, FEMA said more than 10,000 federal staff were on the ground in Puerto Rico and the US Virgin Islands assisting search and rescue and recovery efforts.
President Donald Trump has announced he will visit Puerto Rico on October 3, nearly two weeks after Maria struck the US commonwealth. The President inspected damage and rescue efforts in Texas and Florida in the immediate aftermath of the recent hurricanes.
Defending the federal response in Puerto Rico as "anything but slow" Monday, White House press secretary Sarah Sanders said the administration will be able to determine appropriate funds "once we have a greater insight into the full assessment of damage."
On Tuesday, Trump said the recovery was more difficult in Puerto Rico because of its geography. FEMA administrator Brock Long added that the limited operations at Puerto Rico's international airport were making it difficult to move resources into the area.
CNN's Bill Weir, Brian Vitagliano, Mallory Simon, Eric Levenson contributed to this report.
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Why worry about ticks? This one almost killed me.
The rise of tick-borne diseases has been fueled in part by climate change, and this may be the worst year yet.
Why Worry About Ticks? This One Almost Killed Me
The rise of tick-borne diseases has been fueled in part by climate change, and this may be the worst year yet.
By Phil McKenna
SEP 14, 2017
This story was co-published with WebMD.
The fever started on a Monday morning in June. By Friday, I woke up in a bed at Mount Auburn Hospital in Cambridge, Massachusetts, with yellow skin, an inflamed liver, a dull pain in my stomach and a doctor offering me morphine.
A rotating cast of specialists, residents and medical students began streaming past my bedside as I cowered under a mass of towels and blankets trying to hide from sunlight that was causing my head to throb. Their best guess was that a gallstone was causing bacteria to build up in my bloodstream.
A surgeon recommended a procedure to clear any blockages, sort of like a "Roto-Rooter," he explained, a tad too cheerfully. Then my temperature spiked to 104. If some sort of medical device snaking through my insides could bring relief, I wanted it, now.
Just six days earlier, my wife Rachel and I had celebrated our ninth wedding anniversary watching a dance performance in Harvard Square, less than half a mile from where I lay. Now—after a week of sweat-soaked nights, a full-body rash, episodes of vomiting and violent, shaking chills—Rachel stood anxiously by my bedside, helping me pry my wedding band off my swollen finger as I prepared for surgery.
The author in the field where he was infected by a tick. Credit: Phil McKenna
The author in a nature center where he hikes with his children. Credit: Phil McKenna
When I came to in the recovery room an hour later, but it wasn't because of anything the surgeon had done, he confessed. There was no blockage to clear. He didn't know what explained my symptoms, but he did know one thing: Something was wrong with my liver.
Something was also wrong with my spleen, but that was an old story—I had had it surgically removed before I entered grade school. I mentioned this to the parade of doctors who saw me before and after surgery. In one of them—Vito Iacoviello, the hospital's head of infectious diseases—that piece of my medical history had set off alarm bells and led him to make a quick decision that might have saved my life.
By the time Iacoviello saw me soon after surgery, the results of some initial blood tests had come in, including one for babesiosis, a rare tick-borne disease transmitted by the same tick that carries Lyme disease. He had seen dozens of cases of babesiosis over the years, and he knew how quickly the disease could progress, especially in someone without a spleen. If I was suffering from babesiosis and my condition got much worse, an aggressive form of blood filtering called plasmapheresis might be all that kept me from a coma.
The test for babesiosis came back negative, but Iacoviello started treating me for the disease anyway.
"Given the potential severity of babesiosis in a splenectomized patient, and even though his first smear is negative, I would feel more comfortable covering for this," he wrote in my patient notes that day.
Follow-up tests later confirmed what Iacoviello suspected; I was indeed suffering from babesiosis. It is a potentially fatal parasitic infection carried by the blacklegged tick (more commonly known as a "deer tick").
In my case, the tick probably had caught a ride on my pants a couple of weeks earlier as I led my two young children through a field at a nature center outside Boston. When it bit me and delivered the parasite it was carrying into my bloodstream, what resulted was a harrowing experience that gave me an all-too-intimate view of the growing epidemic of tick-borne disease in the U.S. today.
The spread of these illnesses has been fueled in part by climate change. Warming temperatures have played a key role in the steady rise of tick numbers and northward expansion of their range, all of which has helped give rise to what some are already calling the worst tick season ever.
'I Didn't Realize How Close I Had Come to Dying'
Babesiosis, also known as "Nantucket fever," is caused by the parasite Babesia microti, similar to those that cause malaria. It was first detected on the island off Massachusetts in 1969 and has since spread across much of New England and the northern Midwest. Most people with babesiosis never know they have it. For those with weakened immune systems, however, the infection can be deadly.
Lacking a spleen put me in that danger zone, since the spleen plays a key role in the immune response against blood-borne infections like babesiosis. My spleen had been removed when I was 4 years old as treatment for a rare blood disease, spherocytosis, that I inherited from my dad. The disease makes my red blood cells more sphere-shaped than disk-like, raising the potential for my spleen to not recognize and attack my own red blood cells. Such episodes had plagued my father before he was diagnosed, leading to bouts of jaundice and weakness to the point where he couldn't walk.
I suffered no such attacks as a child, but, once my spleen was removed, I was vulnerable to infections and vigilant about always carrying an arsenal of heavy-duty antibiotics when traveling abroad. I knew how quickly a pathogen could overwhelm my system.
That's what was happening now. Without a spleen to fight off the parasite, the Babesia had entered my bloodstream and begun to decimate my red blood cells. My yellow, jaundiced skin and urine that had turned a dark amber were symptoms of this full-scale assault.
Tiny deer ticks thrive in warmer winters. Credit: California Department of Public Health.
Tiny deer ticks thrive in warmer winters. Credit: California Department of Public Health.
Iacoviello started treating me with antibiotics for babesiosis Friday afternoon soon after surgery but I wasn't out of danger yet. My fever never returned, but my skin turned more and more yellow. By Saturday morning, my urine looked like root beer, and I was put on oxygen as I was increasingly out of breath. A scope that had been pushed down my throat during surgery had left a slight perforation on the wall of my intestine, meaning additional antibiotics and no food for several more days. I hadn't eaten since Wednesday; from the time I entered the hospital to the time I left one week later, I would lose 10 pounds.
On Saturday afternoon, as I lay in my hospital bed overlooking the Charles River, my doctor informed me that my lungs had partially collapsed and were beginning to fill with fluid. He didn't seem too concerned and, with my fever gone, neither was I. I offhandedly mentioned the lung issues to Rachel, who relayed the information to my mom. It wasn't until Monday morning, when, after both had visited with tears in their eyes, that I started to realize how serious my condition had been.
Alone with my laptop on Monday afternoon, I started Googling babesiosis and came across a study from Europe that reported roughly half of all patients with babesiosis, most of whom lacked a spleen, died from the disease. The North American strain of Babesia isn't nearly as potent, but even in the U.S., the mortality rate for those with weakened immune systems, myself included, is still high, roughly 20 percent of hospitalized patients. As the numbers sunk in and I realized how close I'd come to dying, I set down my laptop, put my head in my hands, and sobbed.
Additional medication in the coming days helped drain the fluid from my lungs and, as the antibiotics took effect, my liver and lungs slowly recovered. It helped that I was only 40 years old and, except for the lack of a spleen, relatively healthy and physically fit.
My parents happened to be visiting when I fell ill, and it was comforting having them around while I was hospitalized. My dad is a retired physician and had been preparing me for the possibility of an event like this since I was young. When people without a spleen get sick, he would tell me, they have the potential to get really sick. Of his six biological children, four of us have spherocytosis and have had our spleens removed. (My own two children are, thankfully, unaffected.)To this day, he makes sure that all of us are current on the additional vaccinations we need to take throughout our lives.
I was often overwhelmed by the gaggles of medical professionals who would descend on my room at once, not sure who was who, not sure who I should focus my limited amount of energy on as I explained for the umpteenth time my medical history and what my symptoms were.
When I vented about this to my dad, he let me in on a secret. "Look at their coats," he said. Medical students wear short, hip-length white coats, he told me. Doctors wear coats that come down to their knees.
Acorns, Mice and a Push from Climate Change
About a week after I got out of the hospital, I took my kids to a nearby park for a picnic dinner with some friends from the neighborhood. Everyone was talking about their plans for the weekend: a trip to the Cape, hiking in Vermont, berry picking in the suburbs, areas that I now knew were all, literally, crawling with ticks.
After what I'd been through, their plans sounded so dangerous, even reckless. I jokingly tried to warn them, urge them not to go. Only I wasn't really joking.
More than 300,000 Americans will be infected with Lyme and other tick-borne diseases this year, up from fewer than 15,000 confirmed cases in the 1990s. The cost of treating them is roughly $1 billion per year, leading one U.S. senator to call tick-borne diseases an "epidemic-like scourge."
Epidemiologists knew as early as two years ago that 2017 would be especially bad. High acorn production in New England, ground zero for tick-borne disease in America, triggered an increase in mouse reproduction last year. With mice being a major transmitter of Lyme and other tick-borne diseases —they harbor the pathogens in their bloodstream, and infect almost every tick that bites them—it followed that this year would be a big one for Lyme and other tick borne diseases.
But other, longer-term changes are afoot.
The Deer Tick's expanding range
"Over a 15-year period, the range of Lyme disease in human populations has doubled or tripled," Richard Ostfeld, a senior scientist at the Cary Institute of Ecosystem Studies in Millbrook, New York, said. "I don't know of any other diseases in which a sustained trajectory like that has been observed."
Climate change might play a role in this spread in two ways. As warmer temperatures spread northward, ticks are moving northward, too. Researchers started finding blacklegged ticks in large numbers in Canada beginning in the early 2000s.
"Higher temperatures appear to be a key factor affecting where, and how fast, ticks are colonizing new localities," researchers concluded in last year's National Climate and Health Assessment.
Lyme disease in Canada followed close behind, with official reports climbing from 144 cases in 2009 to nearly 1,000 last year, though the actual number of infections are likely much higher.
"It's gone from being a 'well, that might happen' to a reality," said Nick Ogden, director of the Public Health Risk Sciences Division for the National Microbiology Laboratory of the Public Health Agency of Canada.
In addition, warmer temperatures give ticks, which are only active when temperatures are above freezing, a better chance to survive to adulthood and reproduce. Ticks go through three stages in their two-year life cycle: larva, nymph and adult. At each stage, they need to feed on the blood of a host organism, such as a mouse, a deer or a human, before they can move on to the next stage.
"They are basically going to drop dead within two years," Ostfeld said. "They need to find three hosts within that time, and it is beneficial for them to have that longer warm season."
'Don't Sacrifice Doing What You Love' — But Take Precautions
My experience with babesiosis was enough to make me want never to venture outside again. But that's no way to live. I often think back on what one member of Iacoviello's team told me before I was released from the hospital: Don't sacrifice doing what you love. You can go into areas with ticks, just take precautions.
Now, when I'm planning an outdoor activity I carry a change of clothes, from shoes and socks to pants to long-sleeve shirt, that are treated with permethrin, a powerful insect repellent that kills ticks on contact—and, hopefully, won't cause cancer. I was initially terrified of walking across a mowed lawn or sitting on a blanket in the park. But whenever I'm concerned that I might have been exposed, I check myself for ticks before I go to bed. With each passing day, I'm a little less afraid.
Preventing Tick Bites — at Home and in the Woods
My brush with death has affected my daily life in one other small way. While in the hospital, as nurses took blood samples or adjusted my IV early each morning, I'd watch rowers make their way up and down the Charles River, and I vowed that when I got out, I would join them. I now row twice a week, just a couple of river bends upstream from the hospital, as part of a learn-to-row class. I'm getting better at it, though I still often end up swimming next to my overturned boat rather than rowing in it.
This weekend, I'll take my 6-year-old son on his first remote camping trip on a lake straddling Maine and New Hampshire. It's a trip I'd been looking forward to for the better part of a year, then spent much of the summer trying to get out of.
Now, I'm ready. We'll take a few precautions to meet the challenges of our rapidly changing world. But with a little luck, the biggest scare my son and I have will be from the ghost stories we'll tell sitting around the campfire.
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Can an America First nation get the world’s help after Harvey?
Countries seeking political payback, or simply eager to make a point, by sitting silent is a conceivable, if cruel, reaction to a White House that has been deliberately self-centered and dangerously provocative.
Natural disasters know no political boundaries. And that’s why international humanitarian relief flows so quickly, and in such great and humbling quantities, when hurricanes, earthquakes and tsunamis strike.
But today, with Houston suffering as Mother Nature’s latest victim, will the world’s giving nations step-up and step-in to help American relief efforts?
Or are things in an America First world different?
Questioning the world’s appetite to help Trump’s America at this moment is a serious question.
In the wake of Hurricane Katrina and the New Orleans tragedy that followed, the world was tripping over itself to help George W. Bush and Louisiana. The relief efforts ranged from offers of Afghan cash to deployment of Thai doctors and nurses. The Spanish sent crude oil, electric generators and food rations and Swedes airlifted over an emergency mobile phone network. The outpouring of help was overwhelming.
The downside was the United States was unable to accept and distribute the aid offered by 151 countries. Only $40 million of the $850 million offered in Katrina relief was used, $400 million worth of oil aid sat untouched. It turns out that while America was once pretty good at handing out aid around the world, a Heritage Foundation report made clear the USA is woefully unprepared and unable to accept help from others.
In contrast, the response to Harvey is near deafening silence. Maybe a distracted State Department experiencing attrition is unable to process foreign offers and aid. But it might also be that Trump actively alienates American friends and allies, boasts he is cutting USAID, and makes clear that America First translates into an aid policy of every nation for itself.
Countries seeking political payback, or simply eager to make a point, by sitting silent is a conceivable, if cruel, reaction to a White House that has been deliberately self-centered and dangerously provocative.
And some foreign countries seem disinclined to relieve an American humanitarian crisis when Trump is seen as behaving inhumanely toward his country’s own residents and citizens. Even if foreign policy substance has not yet changed much from Bush to Barack Obama to Trump, the tone has changed, in both its pitch and volume. America’s voice has clearly shifted from collaborative to combative.
So instead of offering a helping hand, foreign leaders might be taking a Justin Timberlake-inspired attitude, with a “what goes around...comes around” approach to foreign aid.
Plus, messing with Texas might have the perceived benefit of allowing aggravated countries the world over to try their hand at messing up the one thing Trump seems to be getting right in the eyes of his voters as he leads a relatively stable and so-far cooperative relief effort.
But Texas can use foreign aid today, and not as many places are offering America help in 2017 as they did in 2005.
One of the few and certainly the most notable, immediate and difficult aid offers has come in from next door. America’s neighbor Mexico did not condition its humanitarian aid for Texas, but made sure to remind Trump it will not pay for a border wall. The Trump administration may reject the help.
In 2005, Mexico sent army convoys and a naval vessel to Texas to support Hurricane Katrina relief efforts, delivering food aid and medical support. Mexican President Vicente Fox ordered the Katrina aid, saving American lives and emphasizing at the time that America and Mexico were “neighbors and friends which should always have solidarity in moments of difficulty.”
Former President Fox is now better known for using YouTube videos to troll President Trump about the “fu*ken wall” than for his advocacy of humanitarian aid to the USA. Mexico has taken offense at Trump’s scorn and threats, objecting to the characterization of Mexicans as rapists, drug dealers and criminals.
Texas, of course, is home to an extraordinary number of Mexican immigrants. Mexico wants to be a good neighbor, but also to help those who are both Mexican citizens and Texas residents. Most other countries, both friends and allies, seem uninterested or disinclined to offer humanitarian aid.
National memory and bilateral goodwill may very well yet bring out the best in other nations wanting to help America. In Italy, I once witnessed how history can guide a nation’s future humanitarian actions. In 1989, I went to Messina, Sicily with Soviet President Mikhail Gorbachev’s wife, Raisa. She went to honor Russian sailors who saved 1,000 people in the devastating 1908 earthquake and to accept Sicilian donated medical devices for survivors of the 1988 Armenian earthquake. It was a moving, positive example of “what goes around comes around.” Even 81 years, two world wars, and a different country later, humanitarian sentiment and support survived.
History and memory must overcome national petulance when it comes to helping nations in need. America’s longstanding friend Israel just kicked into gear with its experienced aid teams for Texas. Belgium may, too, as it has always felt obligated to help the USA ever since Herbert Hoover’s heroically successful post-WWI efforts to save that starving nation.
Whether America and the Trump administration are ready, willing and able to accept the world’s help is still unclear. America should, however, accept help from nearly any nation with the capacity and ability to save Texans and rebuild Houston. Getting aid from others, however, also means a national and moral American commitment to continue giving the world aid the next go-round.
Markos Kounalakis, Ph.D. is a senior fellow at Central European University and visiting fellow at the Hoover Institution. Contact him at markos@stanford.edu or on Twitter @KounalakisM.
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Empty seats: Trump’s top science jobs vacant; others tied to industry.
An analysis by Reveal found that of Trump’s 12 nominees and appointees, six have worked for the industries they would regulate or award contracts to.
Seven months into his term, President Donald Trump hasn’t picked anyone to fill 32 of 44 top federal science positions, and half of those he has nominated have significant ties to the industries they would regulate.
Dozens of federal agencies – overseeing issues from the census to endangered species and the nation’s space program – remain without leaders to advise the White House and cabinet secretaries on science, engineering, health and technology. These officials also are responsible for overseeing the work of agency scientists and billions of dollars in spending on research, education and equipment.
The industry-friendly backgrounds and lack of science credentials of some of Trump’s choices, and the extremely slow pace of filling the rest of the vacancies, have raised questions about how the administration is handling the nation’s highest-ranking science positions. Typically, academics, longtime agency staffers or other experts in their fields fill these leadership posts.
An analysis by Reveal from The Center for Investigative Reporting found that of Trump’s 12 nominees and appointees, six have worked for the industries they would regulate or award federal contracts to. Two candidates – including Trump’s former national campaign co-chairman Sam Clovis, the president’s choice as the Department of Agriculture’s top scientist – have no scientific background.
So far, only two of Trump’s nominees for top science positions at federal agencies have been confirmed by the Senate. Eight others are awaiting a vote. The eventual nominees for all 32 vacant posts would require confirmation, which could drag on for months.
“Staff can only go so far before they hit these empty seats,” said Cristin Dorgelo, who was chief of staff in the White House Office of Science and Technology Policy under President Barack Obama. “I’m most concerned about response to emerging situations, because in those moments, leaders are key, not just for setting the direction of the agencies, but raising up the needs, concerns and gaps to the White House and Congress for attention, action and investment.”
Notable vacancies
No one has been named to permanently fill the four top science posts at the Department of the Interior, including the director of the U.S. Fish and Wildlife Service, which is responsible for protecting endangered species and managing about 150 million acres of public refuges and wetlands inhabited by more than 2,000 species of birds, mammals, fish and other creatures.
Also empty: top roles at NASA, which manages key climate and earth science data-gathering projects, as well as the space program, and three high-ranking science posts at the Department of Commerce, including a leader for the National Oceanic and Atmospheric Administration, which oversees fisheries management, climate and ocean research and more.
The Census Bureau, also part of the Commerce Department, has been leaderless since June, when its director resigned after a confrontation with Congress over the budget for the 2020 U.S. census. Census data are critical for guiding how and where the federal government spends hundreds of billions of dollars a year on health, economic development, education and other services and determining how many seats each state gets in the U.S. House of Representatives.
3 top science leaders confirmed under Obama still hold the posts
The Trump administration also has yet to nominate anyone to fill two undersecretary roles at the USDA that oversee the safety and quality of the nation’s food supply.
Dorgelo said she is especially concerned that vacancies at these key agencies and others, including the Health and Human Services and Defense departments, could hamper the government’s response to major crises, such as the Ebola outbreak.
When the Ebola virus showed up in the United States in 2014, input from these leaders helped the White House “identify immediate technology needs of health workers,” she said. “That led to rapid outreach to the private sector to ask for better innovations, such as the suits those workers would wear. There was a very quick response, from gap identification to creating solutions.”
Critics say the vacancies are evidence of Trump’s lack of interest in incorporating science into policy.
“This administration seems to be a bit different from everything I hear, in that they are much less interested in what the career professionals can contribute, and certainly much less interested in the underlying science that informs policy,” said Andrew Rosenberg, director of The Center for Science and Democracy at the nonprofit advocacy group Union of Concerned Scientists.
Trump’s cabinet secretaries “are coming in with a mandate to do something that is sometimes in opposition to the agencies they’ve been tasked to lead – to effectively hand the agency over to private interests,” he said. “So they’re not looking for science advice, because they’ve already been told what to do.”
The White House did not respond to requests for comment.
No scientific expertise
Trump has named two people with no science background to science posts. Both are awaiting final confirmation by the Senate.
David Wright was nominated to the Nuclear Regulatory Commission, the five-person board responsible for regulating the nuclear power industry and ensuring the safety of nuclear facilities. He studied political science and communications in the mid-1970s and worked for 25 years in public relations, advertising and events planning before serving on South Carolina’s public utility commission.
Clovis, the administration’s nominee for the USDA undersecretary for research, education and economics, would oversee about $2 billion in annual funding for scientific research and about another $1 billion for education.
Clovis is a former professor of business administration at Iowa’s Morningside College. But prior to becoming co-chairman of Trump’s national campaign, he was better known as a right-wing political activist who – via his Sioux City talk radio show – promoted fringe conspiracy theories, including “birtherism,” which falsely claimed that Obama was born in Kenya.
Clovis also has proclaimed himself a skeptic on climate change. At the USDA, he would oversee billions of dollars of federally funded science and education on safeguarding the food supply amid rising temperatures and shifting precipitation patterns.
44 vacant top science leadership positions; 42 require Senate confirmation
Critics say the lack of deep science backgrounds for some candidates means there would be few people in authority capable of informing politicians about an array of complex issues.
“Some positions, such as the undersecretary for research at the Department of Agriculture, benefit very much from robust science backgrounds. Ideally, you get a person who has a mix of both scientific background and experience and policy background,” Dorgelo said. “It’s not possible to hire people with that mix for all positions, but it’s important to hires in key positions, such as that one at the USDA.”
If political appointees have scientific expertise, “they’re able to have a seat at the political policymaking table to make sure science has a voice,” she said.
So far, two of the administration’s top science positions have been filled by experts: Dr. Brenda Fitzgerald, Georgia’s public health commissioner, was appointed director of the Centers for Disease Control and Prevention, and Tony Tooke, a forester who has worked for the U.S. Forest Service since he was 18, was named its new chief.
Industry ties
Six of the Trump administration’s science nominees have close relationships with the industries they will be dealing with on behalf of the public. Their scientific experience varies.
Dr. Scott Gottlieb, confirmed in May as head of the Food and Drug Administration, has worked extensively as a consultant and investor to pharmaceutical and medical firms. The FDA is the agency that reviews and approves new drugs and medical devices.
Gottlieb has served on an advisory board for pharmaceutical giant GlaxoSmithKline and as a venture partner with New Enterprise Associates, a venture capital firm that appears to have invested in dozens of biotech, pharmaceutical and medical equipment startups. He also served as an FDA deputy commissioner under President George W. Bush.
At the Energy Department, Paul Dabbar will coordinate about $5 billion in research and development if he is confirmed as undersecretary for science. He has an undergraduate degree in marine engineering and served as an officer on a nuclear submarine. But for the past 21 years, he has focused on investment banking, working on multibillion-dollar merger and acquisition deals between energy firms as a managing director at JPMorganChase & Co. Dabbar currently sits on the Energy Department’s Environmental Management Advisory Board.
10 people nominated by Trump to top science positions; 2 confirmed by Senate so far
If confirmed as assistant secretary for health at the Department of Health and Human Services, Dr. Brett Giroir will be the top public health adviser to Secretary Tom Price and be responsible for oversight of diverse public health issues, from infectious diseases and vaccinations to family planning and reproductive services.
Giroir would oversee federal protection of the rights and welfare of human subjects in clinical trials – such as those conducted by Houston-based biopharmaceutical firm ViraCyte, where he was named CEO in 2016. He also would direct 6,700 commissioned officers in the U.S. Public Health Service, a medical corps that responds to humanitarian crises, natural disasters such as hurricanes and industrial accidents in the U.S. and overseas.
Giroir’s national profile rose in 2014, when then-Texas Gov. and current Energy Secretary Rick Perry tapped him to lead the state’s Ebola response. At the time, Giroir was the CEO of the Health Science Center at Texas A&M; University, spearheading public-private partnerships to tackle emerging public health threats, from chemical biowarfare to infectious pandemics. Giroir directed the science office at the Defense Department’s Defense Advanced Research Projects Agency from 2004 to 2008.
Ellen Lord, confirmed Aug. 1 as the Defense Department’s undersecretary for acquisition, technology and logistics, worked for more than three decades at Textron Systems, a Fortune 500 Defense Department contractor. She joined the company as a chemist in 1984, rising through the firm’s executive ranks to become president and CEO in 2012.
The undersecretary historically directs the Pentagon on how and where to spend its billions of dollars for research, development, energy and equipment. But initially, Lord will oversee a Congress-mandated split of its responsibilities into two offices. Reports suggest she will seek reappointment to the new acquisitions role that results.
The Nuclear Energy Institute, an industry trade group, has endorsed both of the Trump administration’s nominees to the Nuclear Regulatory Commission.
David Wright, an energy industry consultant, has held several positions aligned with the nuclear power industry. These include chairman of the Nuclear Waste Strategy Coalition, a group of utility commissioners and industries that has advocated for a nuclear waste storage site at Nevada’s Yucca Mountain, and president of the National Association of Regulatory Utility Commissioners.
The other commission nominee, Annie Caputo, was an executive assistant and legislative affairs manager for Exelon Corp., the nation’s largest utility and largest operator of nuclear power plants, from 1998 to 2005. She worked for a year as an engineer with Commonwealth Edison after earning an undergraduate degree in nuclear engineering in 1996. She currently is a policy aide for House and Senate Republicans on committees overseeing the industry.
Roots in conservative think tanks
Three of Trump’s science nominees have worked with the nation’s leading conservative think tanks.
Gottlieb was a resident fellow at the American Enterprise Institute when he was confirmed as head of the FDA. The institute advocates for free enterprise and limited government authority. One of its campaigns is to overturn FDA regulations on electronic cigarettes.
Economist Stephen Parente, nominated as assistant secretary for planning and evaluation at the Department of Health and Human Services, would manage Medicare and some elements of the Affordable Care Act if confirmed. He has written critical reviews of the act for the right-leaning think tank American Action Forum, including analyses of House Speaker Paul Ryan’s “A Better Way” replacement proposal. Parente is a health economist at the University of Minnesota, where he is the Minnesota insurance industry chair of health finance.
2 science leaders appointed by Cabinet secretaries
Kevin Hassett, nominated to lead the president’s Council of Economic Advisers, was a professor at Columbia University in New York and an economic adviser for the Federal Reserve Board in the 1990s. He advised the Republican presidential campaigns of George W. Bush, John McCain and Mitt Romney. He is currently the director of research for domestic policy for the American Enterprise Institute, an outspoken opponent of federal policies to combat climate change. Hassett, however, has endorsed carbon taxes as a more effective incentive to reduce greenhouse gas pollution than cap and trade.
Rosenberg of the Union of Concerned Scientists said he is worried but not surprised that there are so many science vacancies and that many of the nominees have ties to the industries they would oversee.
“There seems to be very little interest in utilizing those resources or advisory bodies. Even the external advisory bodies have really ground to a halt,” he said. “The philosophy of this administration is that the most important thing we can do is deregulate.”
This story was edited by Marla Cone and Amy Pyle and copy edited by Nadia Wynter and Nikki Frick.
Emily Gertz can be reached at ejgertz@emilygertz.com. Follow her on Twitter: @ejgertz.
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